When to start tennis elbow exercises
Tennis Elbow? Absolute Best Self-Treatment, Exercises, & Stretches.
Bob and Brad the two most famous
physical therapist on the Internet
hi I'm Bob Shrum physical therapist red
Hynek physical therapy we have the most
famous physical therapist on the
internet in our opinion of course Bob
Brad we've done a video on this before
but we're going to do kind of a
comprehensive one this is on tennis
elbow and these are the absolute best
treatment stretches and exercises you
can do in our episode and you've had
tennis elbow on both arms so you you're
you're a good sub a it's a very painful
when it's in in it's you know it's very
it's painful and it limits you a lot
people I think they're shocked how much
it hurts and the thing about this is is
you look perfectly healthy it looks
perfectly fine and you can just do the
smallest little motion like opening a
door and it just will bite and it lets
you know right now III yeah so alright
so what first thing is you know normally
what it involves it is the muscle going
into the tendon and attaching to the
bone here nine times out of ten that's
what it is
yeah and you're going to interrelate
generally a lot of times it's going to
hurt when you when you squeeze your hand
or bring your wrist up or deviate a
little bit this way that's the indicator
because it'll hurt down there those
muscles go all the way down the forearm
salt right I know one thing I do when I
have a patient
I'll palpate or feel on that bone and
usually where that bone is that connect
yeah very tender spot in there yeah all
right so you're going to start off with
ice massage I mean and maybe this is
something you've done already Brad you
watch Brad that's done yep you can just
take direct ice fill a cup up it can be
styrofoam or paper Bob likes to start
from I like paper ones better but it
doesn't matter fill it about this high
put it in the freezer so it doesn't tip
over freeze it solid and then peel away
the top so you have some ice exposed you
can rub the ice to get the sharp edges
off and go right over that area
I usually rub for five minutes the first
one or two minutes it kind of burns and
is little uncomfortable but then it goes
numb skin turns red and in five minutes
and I think you even do a little less
than that don't you by you I I mean if
you're really busy you can probably do
it in two three minutes it's going to
help it's going to help the second thing
that you may want to go ahead and invest
in a
race a tennis elbow brace yeah I like
the one by air cast here just me
personally Brad up it's worked well with
patience
it's nice these they have a bladder on a
little air bubble thing there and you
usually put that over the sore area and
on the muscle belly just in front of it
stuff right there was a sore spot we're
going to go right in front of it and
you'll know because when you're on it
and you tighten this nut on the sore
area just a little bit off of it more
towards the hand exactly I thought I
said that it was a little confusing I
know I didn't say it very well did I but
what you're trying to do is take you
know the muscle the stress of the muscle
now is is a little bit more right here
instead of where it attaches right kind
of spreads it out did you use a brace
pad or not
yeah I use one and one thing I found
within other people have some patience
so mine is to get it in the right spot
sometimes when you're working if you're
working that physical type job and you
bend it it will get in the crux of your
elbow and it's uncomfortable so then it
would kind of bother you it all depends
on your situation but they are helpful
it was anyway it doesn't take away the
problem but it it seems to hell at least
you can work with it as long as your
elbows not real flexed a lot okay first
treatment you may want to do just just a
bob just wait right oh yeah by the way
before we go any further we want to make
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on alright moving on this is a this is a
very low level exercise but just to
start putting a little bit of stress on
the area without making it worse so all
you going to do is every you know
throughout the day you can do this every
hour in fact it's all you're going to do
is lift your make a fist and squeeze
you're going to feel a little bit of
pain but that's okay squeeze you don't
want to go to the sharp pain but a
little bit you do this ten times like I
said four to five times a day and you
notice he's got his wrist up we call
that extended that's the extended
position of the wrist and that's where
you want it not
like this all right now this next one is
one that we found a lot of people have
had a lot of help with Lonnie can you
throw me a pillow there's one over there
he meant to say a lot of success what
did I say help
oh well it's kind of true to it but it
has been a nice and it's not real hard
to do you can do it to yourself
so what we're going to do is yeah we're
cross-fiber friction massage you're
going to find the spot here right off
the bone and you're going to move a
little bit more towards the hand and see
the spot where you're going to you're
going to do this and you're going to
take one finger or two fingers you're
going to go across the fibers the fibers
are the muscles go this way so we're
going to take in the massage and go this
way yep
and what this does it because a lot of
times what has happened over time is
that scar tissue has formed in that
tendon or even a little bit in the
muscle Brad yeah and that scar tissue is
very weak and it breaks open very easily
so what happens is it starts to heal and
you think oh it's getting better
and then you use it and breaks open and
you starts all over again sure so this
helps it heal strong so like this in
instead of like a cobweb right we don't
yeah that's kind of we've got some other
things okay but it is definitely a nice
technique that's oh you're going to
you're going to go across like this and
you can do this for a good five minutes
if you can tolerate it and you can do
this every day if you like right if you
can tolerate it you'll know if it's the
right technique because when you start
will be a little painful but within 30
seconds to a minute the pain should
start decreasing it might be very
painful to start off and but yeah it
should level off at least if it's
getting worse and worse and worse as you
do this it may be too soon right you may
have to ice your back to give it a
little rest for a day or two put the
cold packs back on yeah
all right what we're going to do right
now Brad is so this is a great one to do
I really want you to focus on this was
probably one of the ones that will be
most helpful sure but we're also going
to show you some other techniques that
are maybe more for those stubborn types
of elbow that don't go away because
quite often what we'll see in people who
have tennis elbow is that that
particular elbow doesn't straighten as
much as the other L air not sometimes
you can compare the two and you'll see
it's just slightly bent and then these
techniques work out really well for this
so we're going to show the first one up
so if you find a doorway I'm
going to simulate this that this is a
doorway here you know I'm inside the
doorway what you're going to do is
you're actually trying to move this
lower floor arm that way while this is
supported by the doorway sure so it's
it's a little mobilization we're calling
it so I don't know if you can see it in
the camera you know here's a corner you
can you know it's just a molding of the
door a door jamb per head will keep your
thumb up okay
and while the thumb is up I'm taking you
know writing here in the between the
thumb and the first finger here and
pushing pushing and while I'm pushing
I'm pushing continuously I'm going to go
ahead and squeeze my hand like this and
while you're doing this it should feel
better right no pain with this this what
you can do first bad is do it this way
and that hurts yep okay you might even
squeeze a washcloth sure then you do it
this way and squeeze and it should feel
better if it does you know you're doing
there is I think this is a good
technique if it does that it's do you're
doing the right thing you can even do it
at different bends red you can do it
straightened okay and doing it different
way I had a golfer that she was a
semi-pro golf or okay and this actually
is what took work for her yup go ahead
well go back alright going back to some
of the other techniques now these are
different techniques for you to try and
see which one's work for you right again
if the elbow is not straining all the
way one technique very simple technique
they do is actually just have you turn
your arm this way and you just let it
drop sure you do that ten times and
you're doing kind of a little self
mobilization on the elbow and you know
you're doing the right thing is each
time you do it it feels a little bit
better yeah yep exactly if by some
reason it feels worse each time then
you'll stop the one I liked the one I
when I get a little bit of pain Brad I
actually just take my arm and I turn it
this way the hand is facing me and then
I go this way I turn it even a little
farther and bend it so he's rotating
low-rated this way the palma well in
this situation ten times I did want to
bring up something about this one I know
what patients have had and my own
experience is when you get out of bed
really painful obviously you're not
going to do this one early in the
morning you gotta be upbeat you might
try this one that that might that might
be work and it you can also go the other
direction where you turn the palm away
from you and turn it this way
and again I'm twisting it and bending it
at the same time and again if one of
these directions feels better with
repetition that's when you're going to
stick with because usually one will and
one will probably go on again that
worked for me i like i like this one i
would do it both directions actually it
worked out both way they're all worked
out for me another one to do brad this
one might be easier than the one we just
showed up against the wall you know put
your arm down your fingers are pointed
toward you okay like this elbow as
straight as you can
tie out of the way and now i again i'm
doing the same thing i'm pushing that
way yeah let's give them a different
view here so okay
forces that direction so pressure on
pressure off okay
pressure on pressure off about ten times
differently pressure off you have ten
times again we're looking for positive
results as you know smaller yep does
feels better as you do more
finally when when the pain is better you
want to do some strengthening Brad's
your show the eccentric strength you bet
I like to use stretch band or tubing
like this you can use like a dumbbell I
just think this is easier to vary the
resistance you're going to go down like
this take the other hand you're going to
help it up this is when you're starting
and then you're going to let it down
slow is called eccentric or negatives
which is a really good way to strengthen
a muscle jiù jiù jiù and as it gets
better you know maybe you can go into
the typical sure concentric yep
initially the eccentric really does help
healing right this is this is a really
gets directly to that I can feel these
muscles starting to burn already just
after them it looks easy but it's not
exactly alright if there's any other
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